MEDICARE: DR. ELENA FARFEL DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5999	NV

General Provider Information

NPI Number	:	1114234770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELENA FARFEL DMD

Provider Business Mailing Address
First Line	:	4451 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3405
Country	:	US
Telephone Number	:	702-313-6868
Fax Number	:	702-313-6873

Provider Business Practice Location Address
First Line	:	4451 N RANCHO DR
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89130-3405
Country	:	US
Telephone Number	:	702-313-6868
Fax Number	:	702-313-6873

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2010
Last Update Date	:	09/02/2010

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